脊髄小脳変性症における神経耳科学的所見

概要

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Forty patients with spino-cerebellar degeneration were examined neurotologically. The chief findings were as follows:1) Spontaneous nystagmus was relatively rare, but gaze paretic nystagmus, direction-changing positional nystagmus (especially apogeotropic type) and counter-beating vertical positioning nystagmus were observed very frequently.2) Rebound nystagmus, flutter-like oscillation and transitory alternating saccade were observed in five to eleven patients.3) Saccadic dysmetria and disturbance on rapid, alternating change of gaze were remarkable in about two-thirds of the patients, though the velocity of saccade itself was not influenced by the disease.4) Optokinetic nystagmus and smooth pursuit movement were impaired in 80-90% of the patients.5) The release phenomenon of cerebellar and/or brainstem inhibition of the vestibulo-ocular reflex was seen during the visual suppression test (after Takemori) and pendular rotation.6) Disturbance of gaze control and change in the vestibulo-ocular reflex seemed to be important in the diagnosis of the cerebellar and/or brainstem lesions.
耳鼻咽喉科臨床学会の論文